Improved understanding of ongoing transmission of leprosy in the Comoros, a region hyperendemic for the disease

Intensive investigation of the epidemiology of leprosy in Anjouan, the most endemic of the four islands in the Comoros, is proposed. The team is strong, with good local representation, and long-standing support from the Damien Foundation in Belgium. The project starts with retrospective mapping of all incident cases (which are well-documented) over the past 16 years, to identify hot-spots and trends. A prospective study of new cases will involve PGL-1 and cytokine analysis of all cases and their contacts, while M. leprae strain-typing will be carried out on samples from MB patients. Chemoprophylaxis with single-dose rifampicin has been started recently in four villages, so the effect of this intervention can be observed and compared with other villages as controls.